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201607453
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Last modified
7/3/2017 5:40:21 PM
Creation date
11/7/2016 11:59:40 AM
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DEEDS
Inst Number
201607453
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OR <br />10a. ORGANIZATIONS NAME <br />lob. INDIVIDUAL'S SURNAME <br />INDIVIDUAL'S FIRST PERSONAL NAME <br />INDIVIDUAL'S ADDITIONAL NAME(S) / INITIAL(S) <br />SUFFIX <br />10c. MAILING ADDRESS <br />CITY <br />STATE <br />POSTAL CODE <br />COUNTRY <br />11. <br />OR <br />ADDITIONAL SECURED PARTY'S NAME Am ❑ ASSIGNOR SECURED PARTY'S NAME: Provide only one name (1la or 11b) <br />11a. ORGANIZATIONS NAME <br />11b. INDIVIDUAL'S SURNAME <br />FIRST PERSONAL NAME <br />ADDITIONAL NAME(S)/INITIAL(S) <br />SUFFIX <br />11c. MAILING ADDRESS <br />CITY <br />STATE <br />POSTAL CODE <br />COUNTRY <br />10. DEBTORS NAME: Provide (10a or 10b) only one additional Debtor name or Debtor name that did not fit in line 1b or 2b of the Financing Statement (Form UCC1) (use exact, full name. <br />do not omit, modify, or abbreviate any part of the Debtor's name) and enter the mailing address in line 10c <br />UCC FINANCING STATEMENT ADDENDUM <br />FOLLOW INSTRUCTIONS <br />9a. ORGANIZATIONS NAME <br />Gill Farms, Inc. <br />9b. INDIVIDUAL'S SURNAME <br />FIRST PERSONAL NAME <br />ADDITIONAL NAME(S) /INITIAL(S) <br />SUFFIX <br />9. NAME OF FIRST DEBTOR: Same as line la or 1b on Financing Statement; if line lb was left blank <br />because Individual Debtor name did not fit, check here ❑ <br />OR <br />12. ADDITIONAL SPACE FOR ITEM 4 (Collateral): <br />13. 123 This FINANCING STATEMENT is to be filed [for record] (or recorded) in the <br />REAL ESTATE RECORDS (if applicable) <br />15. Name and address of a RECORD OWNER of real estate described in item 16 <br />(if Debtor does not have a record interest): <br />Don Gill <br />Laurel Gill <br />4499 S Bluff Center Rd <br />Shelton NE 68876 <br />17. MISCELLANEOUS: <br />16. Description of real estate: <br />20 1607453 <br />THE ABOVE SPACE IS FOR FILING OFFICE USE ONLY <br />14. This FINANCING STATEMENT: <br />0 covers timber to be cut 0 covers as- extracted collateral is filed as a fixture filing <br />Part of the S1 /2 NW1 /4, Section 4, Township 10 North, Range 12 <br />West, Hall County, Nebraska. <br />International Association of Commercial Administrators (IACA) <br />FILING OFFICE COPY — UCC FINANCING STATEMENT ADDENDUM (Form UCC1Ad) (Rev. 04/20/11) <br />
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